| MicrobiologyBytes: Virology: HGV | Updated: October 19, 2004 | Search |
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HGV infection was originally suggested to be connected with fulminant hepatitis, but recent studies have failed to prove a connection between HGV and clinical illness. Some studies have suggested that in contrast to HCV, the liver is not the primary replication site for HGV (e.g. Tucker T.J. et al (2000) Evidence that the GBV-C/hepatitis G virus is primarily a lymphotropic virus. J.Med.Virol. 61: 52-8). Where does HGV grow? Virus circulating in the bloodstream is difficult precipitate with antibody to immunoglobulins, but can precipitated with antibody to apolipoproteins. Since no hypervariable regions have yet been identified in the envelope proteins of HGV, the lipoprotein coat may help the virus evade immune surveillance and contribute to its persistence.
In many countries, 1-2% of blood donors test positive for HGV RNA & the prevalence of HGV infection is up to 10-15% in West African children. How this high prevalence is maintained is unknown, but this does suggest that sub-clinical infection is common. Antibodies to E2, an envelope protein of HGV, can be detected in >50% IVDAs who are HGV RNA negative, but in relatively few IVDAs who have HGV RNA. Therefore, HGV infection is probably much more frequent than studies of the prevalence of HGV RNA suggest.
The virus is transmitted by the same routes as HCV & co-infection is common; however, this may represent a common source of infection rather than any clinical similarity between the two viruses. The clinical significance of HGV infection and HGV-HCV co-infection remains to be fully elucidated, but at present does not seem to be a major disease-causing factor. The majority of patients infected with HGV by blood transfusion do not develop chronic hepatitis, but viremia frequently persists without biochemical evidence of hepatitis. Given the high prevalence of HGV worldwide and the association with mild or no clinical illness, is HGV merely an accidental tourist that occasionally travels with other hepatitis viruses?
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Viruses are obligate intracellular parasites. But does parasite = pathogen ? Not necessarily. Some viruses are commensal in nature - for example, HGV and TTV - the accidental tourists. |
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